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Kurosawa S, Imafuku K, Nakakubo S, Iwasaki S, Teshima T, Goto H, Ujiie H. Pseudotumor of the skin due to Mycobacterium genavense. Int J Infect Dis 2023; 134:88-90. [PMID: 37196757 DOI: 10.1016/j.ijid.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 04/24/2023] [Accepted: 05/02/2023] [Indexed: 05/19/2023] Open
Abstract
Mycobacterium genavense is a rare type of nontuberculous Mycobacterium that has been reported to cause disseminated infections in patients who are immunocompromised. Because M. genavense is slow-growing and poorly able to form colonies on Ogawa medium, genetic and molecular analyses are necessary to identify this pathogen. Nontuberculous Mycobacterium infections present with various cutaneous manifestations. Of these, rare cases have been reported to present with mycobacterial pseudotumors. However, there are no reports of M. genavense with cutaneous pseudotumors. In this paper, we report a case of a pseudotumor due to M. genavense infection that was observed only in a cutaneous lesion. The patient was taking 5 mg of prednisolone and was aware of a tumor on the right lower leg. Biopsy samples showed diffuse spindle-shaped histiocytes and various other inflammatory cell infiltrates, and Ziehl-Neelsen staining detected Mycobacterium. Because no colonies formed on the Ogawa medium, genetic testing was performed, and M. genavense was identified by DNA sequence analysis. There were no other disseminated lesions beyond the skin, including in the lungs and liver. Because the patient was immunosuppressed, in accordance with previous literature, a combination therapy of clarithromycin, ethambutol, and rifampicin for 4 months was recommended. When no growth is observed on the Ogawa medium in cases of infection, it is essential to identify the infectious pathogen by genetic analysis.
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Affiliation(s)
- Suguru Kurosawa
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Keisuke Imafuku
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - Sho Nakakubo
- Department of Infection Control, Hokkaido University Hospital, Sapporo, Japan
| | - Sumio Iwasaki
- Department of Infection Control, Hokkaido University Hospital, Sapporo, Japan; Department of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Takanori Teshima
- Department of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Hideki Goto
- Department of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan
| | - Hideyuki Ujiie
- Department of Dermatology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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2
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Monge E, Garapin B, Lucas MN, Gaide N, Le Loc'h G, Donnelly TM, Delverdier M. Concurrent Mycobacterium genavense infection and intestinal B-cell lymphoma in a pet rabbit (Oryctolaguscuniculus). J Comp Pathol 2023; 204:1-6. [PMID: 37269779 DOI: 10.1016/j.jcpa.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/19/2023] [Accepted: 04/25/2023] [Indexed: 06/05/2023]
Abstract
A 6-year-old male intact pet rabbit was evaluated for chronic weight loss. A large mass was detected by palpation in the mid-abdomen and ultrasound examination suggested a jejunal location. Explorative laparotomy revealed a nodular mass within the jejunal wall. Histological examination of a biopsy revealed mycobacterial granulomatous enteritis with an atypical lymphoblastic proliferation suggestive of lymphoma. Neoplastic lymphocytes were immunopositive for Pax-5 but negative for CD3, which is diagnostic of a B-cell neoplasm. Numerous acid-fast bacteria were seen within histiocytes and identified by polymerase chain reaction as Mycobacterium genavense, which is a non-tuberculous and opportunistic mycobacterium with zoonotic potential. To the best of our knowledge, this is the first documented case of a concurrent B-cell lymphoma and M. genavense infection in a rabbit. Concomitant mycobacteriosis and lymphoma have been rarely described in animals and the coexistence of neoplasia and mycobacterial infection within the jejunum suggests a potential pathogenetic association. Interestingly, the rabbit owner worked in an anti-tuberculosis clinic, and an anthropic origin of the mycobacterial infection could not be excluded.
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Affiliation(s)
- Emma Monge
- Zoological Medicine Department, Université de Toulouse, ENVT, Chemin de Capelles, Toulouse, 31076, Occitanie, France; IHAP, Université de Toulouse, INRAe, ENVT - Toulouse, 31076, Occitanie, France.
| | - Bénédicte Garapin
- IHAP, Université de Toulouse, INRAe, ENVT - Toulouse, 31076, Occitanie, France; Department of Basic Sciences, Université de Toulouse, ENVT Chemin de Capelles, Toulouse, 31076, Occitanie, France
| | - Marie-Noëlle Lucas
- Laboratoire d'Anatomie Pathologique Vétérinaire du Sud-Ouest, All. des Vitarelles, Toulouse, 31100, France
| | - Nicolas Gaide
- IHAP, Université de Toulouse, INRAe, ENVT - Toulouse, 31076, Occitanie, France; Department of Basic Sciences, Université de Toulouse, ENVT Chemin de Capelles, Toulouse, 31076, Occitanie, France
| | - Guillaume Le Loc'h
- Zoological Medicine Department, Université de Toulouse, ENVT, Chemin de Capelles, Toulouse, 31076, Occitanie, France; IHAP, Université de Toulouse, INRAe, ENVT - Toulouse, 31076, Occitanie, France
| | - Thomas M Donnelly
- Exotic Animal Service, CHUVA, École Nationale Vétérinaire d'Alfort, Av. du Général de Gaulle, Maisons-Alfort, 94700, France
| | - Maxence Delverdier
- Zoological Medicine Department, Université de Toulouse, ENVT, Chemin de Capelles, Toulouse, 31076, Occitanie, France; IHAP, Université de Toulouse, INRAe, ENVT - Toulouse, 31076, Occitanie, France
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Vilstrup E, Dahl VN, Fløe A, Degn KB. Disseminated Mycobacterium genavense infection in a patient with a history of sarcoidosis. BMJ Case Rep 2023; 16:e254792. [PMID: 37147106 PMCID: PMC10163504 DOI: 10.1136/bcr-2023-254792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2023] Open
Abstract
We present a case of Mycobacterium genavense infection in a man in his 60s with a history of sarcoidosis, treated for 24 years with systemic corticosteroids and later methotrexate as monotherapy. He presented with low grade fever, dyspnoea and right-sided thoracic pain and was admitted due to a treatment-refractory infection. After a prolonged period of symptoms and diagnostics, acid-fast bacilli were demonstrated in pleural fluid and PCR revealed M. genavense The patient was treated with intravenous amikacin, peroral azithromycin, rifampicin and ethambutol for a total of 18 months, with a good clinical and radiological treatment response. Infection with M. genavense is rare in HIV-negative immunocompromised hosts. Diagnosing and treating mycobacterial infections, especially for more rare species, remains a challenge as clinical evidence is sparse. Nonetheless, the disease-causing infection must be considered in symptomatic and immunocompromised patients.
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Affiliation(s)
- Emil Vilstrup
- Department of Internal Medicine Viborg, Viborg Regional Hospital, Viborg, Denmark
| | - Victor Næstholt Dahl
- Department of Infectious Diseases, Aarhus University Hospital, Aarhus N, Denmark
- Center for Global Health (GloHAU), Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - Andreas Fløe
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus N, Denmark
| | - Kristine Bruun Degn
- Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus N, Denmark
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Mycobacterium genavense Central Nervous System Infection in a Patient with AIDS. Can J Neurol Sci 2023; 50:305-307. [PMID: 35220993 DOI: 10.1017/cjn.2022.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Artigues Serra F, García-Gasalla M, Campins A, González de Cabo M, Morales R, Peña RR, Gallegos MC, Riera M. Sclerosing mesenteritis due to Mycobacterium genavense infection: A case report. Medicine (Baltimore) 2022; 101:e30351. [PMID: 36086677 PMCID: PMC10980495 DOI: 10.1097/md.0000000000030351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/20/2022] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Since its first identification in the early 1990s, Mycobacterium genavense has been considered and opportunistic pathogen. It mainly causes gastrointestinal symptoms, but also disseminated infections in severely immunosuppressed patients. Sclerosing mesenteritis is a long-term complication with high morbidity and mortality. As it is a rare condition, there are no specific guidelines for its management. We report a challenging case of persistent M. genavense infection, and propose surgery as an alternative treatment strategy. PATIENT CONCERNS A 38-year-old Caucasian man presented to the emergency room with fever, abdominal pain, and night sweats for 3 months. HIV screening revealed a previously unknown HIV-1 infection, with a CD4 cell count of 216 cell/µL and viral load of 361.000 copies/mL at diagnosis. A body CT-scan showed mild splenomegaly as well as mesenteric and retroperitoneal enlarged lymph nodes. Fine needle aspiration revealed the presence of acid-fast bacilli, but mycobacterial cultures were negative. In the second sample, 16S RNA sequencing yielded a diagnosis of M. genavense infection. Despite 2 years of corticosteroids and antimycobacterial treatment excluding rifampicin due to a severe cutaneous reaction, there was no clinical improvement and an increase in the mesenteric lymph node size was observed, with a sclerosing transformation of the mesentery. A surgical approach was proposed to release small bowel loops and to remove fibrin. A second surgery was required due to an acute peritonitis ought to yeyunal segmental isquemia and perforation. Finally, the patient evolved favorably, and antimycobacterial drugs were suspended without relapse. LESSONS Despite a prolonged multidrug strategy, some patients develop persistent M. genavense infection. Once sclerosing mesenteritis is established, clinicians have few treatment options. Surgery should be considered in patients with sclerosing mesenteritis or bowel obstruction. The combination of medical and surgical treatment could be a potential cure for these patients.
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Affiliation(s)
- Francisca Artigues Serra
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases-IdISBa, Palma, Spain
| | - Mercedes García-Gasalla
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases-IdISBa, Palma, Spain
| | - Antoni Campins
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases-IdISBa, Palma, Spain
| | | | - Rafael Morales
- Peritoneal Surface Malignancies Unit, General and Digestive Surgery Department, Hospital Universitari Son Espases-IdISba, Palma, Spain
| | - Rebecca Rowena Peña
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases-IdISBa, Palma, Spain
| | | | - Melchor Riera
- Infectious Diseases Unit, Internal Medicine Department, Hospital Universitari Son Espases-IdISBa, Palma, Spain
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High overall mortality of Mycobacterium genavense infections and impact of antimycobacterial therapy: Systematic review and individual patient data meta-analysis. J Infect 2021; 84:8-16. [PMID: 34788633 DOI: 10.1016/j.jinf.2021.10.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/20/2021] [Accepted: 10/30/2021] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Mycobacterium genavense is a fastidious slow growing mycobacterium (SGM) that causes disseminated infections in immunocompromised hosts. It has been described in HIV-positive individuals and increasingly in patients without HIV. The infections are difficult to treat and the optimal antimycobacterial regimen is still unknown. METHODS An individual patient data meta-analysis was conducted aiming at including all hitherto published cases of infection with M. genavense. Clinical manifestations, microbiological data, dispositions and immunosuppression were recorded. Antimycobacterial therapies and mortality were analyzed by logistic regression and time-to-event analysis. RESULTS We included 223 patients with infection due to M. genavense published from 1992 to 2021. While the majority was HIV positive (n = 171, 76.7%), 52 patients were non-HIV-patients (23.3%), 36 of whom received immunosuppressive therapy (69%). We could confirm the bacterium's tropism for the gastrointestinal tract with abdominal pain, hepato-/splenomegaly and abdominal lymphadenopathy being major clinical manifestations. More than 90% of patients received antimycobacterial therapy. The regimens consisted mainly of macrolides, rifamycins and ethambutol. Overall mortality was high, but in logistic regression and time-to-event analysis a macrolide containing regimen was associated with better outcomes. CONCLUSION In this first individual patient data meta-analysis of infections with M. genavense we confirm its tropism for the gastrointestinal tract. The high overall mortality underlines the clinical relevance of infection with this bacterium for the individual patient. In addition, our data give a hint that a macrolide containing regimen is associated with better survival.
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Eskandari SK, Jonkers SY, Almesned MAM, Akkerman OW, Verschuuren EAM, Gan CTJ. Recurrent fever 3 years post-lung transplantation: A treacherous case of Mycobacterium genavense. Transpl Infect Dis 2021; 23:e13741. [PMID: 34607392 DOI: 10.1111/tid.13741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 09/15/2021] [Accepted: 09/18/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Siawosh K Eskandari
- Department of Pulmonary Disease and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Transplantation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sterre Y Jonkers
- Department of Pulmonary Disease and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Mohammad A M Almesned
- Department of Pulmonary Disease and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Onno W Akkerman
- Department of Pulmonary Disease and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Tuberculosis Center Beatrixoord, University Medical Center Groningen, University of Groningen, Haren, Netherlands
| | - Erik A M Verschuuren
- Department of Pulmonary Disease and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Christiaan Tji-Joong Gan
- Department of Pulmonary Disease and Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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Manion M, Lynn N, Pei L, Hammoud DA, Laidlaw E, Roby G, Metzger D, Mejia Y, Lisco A, Zelazny A, Holland S, Vachon ML, Scherer M, Bergin C, Sereti I. To Induce Immune Reconstitution Inflammatory Syndrome or Suppress It: The Spectrum of Mycobacterium genavense in the Antiretroviral Era. Clin Infect Dis 2021; 72:315-318. [PMID: 33501968 DOI: 10.1093/cid/ciaa753] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Accepted: 06/13/2020] [Indexed: 11/13/2022] Open
Abstract
Mycobacterium genavense is a challenging opportunistic pathogen to diagnose and manage in patients with human immunodeficiency virus (HIV). Persistent immunosuppression or protracted immune reconstitution inflammatory syndrome can lead to complicated clinical courses. We describe 3 cases of M. genavense in patients with HIV representing the spectrum between disease burden and strength of immune response.
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Affiliation(s)
- Maura Manion
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | | | - Luxin Pei
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Dima A Hammoud
- Center for Infectious Disease Imaging, Radiology and Imaging Sciences, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Elizabeth Laidlaw
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Gregg Roby
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Dorinda Metzger
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | | | - Andrea Lisco
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Adrian Zelazny
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Steve Holland
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
| | - Marie-Louise Vachon
- Centre hospitalier universitaire de Quebec-Université Laval, Quebec City, Quebec, Canada
| | - Matthew Scherer
- Division of Infectious Diseases, Department of Internal Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | | | - Irini Sereti
- National Institute of Allergy and Infectious Diseases, Bethesda, Maryland, USA
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Murata Y, Mori N, Kagawa N, Okuma K, Yoshida S, Ohkusu K, Honda M. Acid-fast bacilli smear test of a blood culture sample for the diagnosis of disseminated Mycobacterium genavense infection: A case report. Int J STD AIDS 2021; 32:483-485. [PMID: 33570479 DOI: 10.1177/0956462420972224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Mycobacterium genavense, a nontuberculous Mycobacterium, is found in immunosuppressed patients, particularly in those with HIV. Mycobacterium genavense incubation under standard culture conditions is difficult, and its identification is challenging using routine culture methods. Herein, we report the case of a 40-year-old Japanese man with HIV presenting with disseminated M. genavense infection. An analysis using an automated blood culture system did not show positive signals during 6 weeks of incubation. However, an acid-fast bacilli smear of his blood sample was positive for the bacterium. Mycobacterium genavense was identified using sequencing analysis, targeting the heat shock protein 65 gene. The patient recovered from the infection, following antibiotic therapy for 18 months. Under suspicion of disseminated M. genavense infection and the absence of bacterial growth in blood culture samples, an acid-fast bacilli smear test of the sample may be useful for timely diagnosis.
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Affiliation(s)
- Yo Murata
- Department of General Internal Medicine and Infectious Diseases, 38547National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Nobuaki Mori
- Department of General Internal Medicine and Infectious Diseases, 38547National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Narito Kagawa
- Department of Clinical Laboratory, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kentaro Okuma
- Department of General Internal Medicine and Infectious Diseases, 38547National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Shinji Yoshida
- Department of General Internal Medicine and Infectious Diseases, 38547National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kiyofumi Ohkusu
- Department of Microbiology, 13112Tokyo Medical University, Tokyo, Japan
| | - Miwako Honda
- Department of General Internal Medicine and Infectious Diseases, 38547National Hospital Organization Tokyo Medical Center, Tokyo, Japan
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Improved Prognosis of Infection With Mycobacterium Genavense in Immune-Compromized HIV Patients After Introduction of Combined Antiretroviral Therapy. J Acquir Immune Defic Syndr 2021; 86:e9-e12. [PMID: 32947445 DOI: 10.1097/qai.0000000000002513] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Dequéant B, Pascal Q, Bilbault H, Dagher E, Boschiroli ML, Cordonnier N, Reyes-Gomez E. Identification of Mycobacterium genavense natural infection in a domestic ferret. J Vet Diagn Invest 2019; 31:133-136. [PMID: 30475677 PMCID: PMC6505761 DOI: 10.1177/1040638718812137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A 6-y-old neutered male ferret ( Mustela putorius furo) was presented because of a 1-mo history of progressive weight loss, chronic cough, and hair loss. On clinical examination, the animal was coughing, slightly depressed, moderately hypothermic, and had bilateral epiphora. Thoracic radiography was suggestive of severe multinodular interstitial pneumonia. Abdominal ultrasound examination revealed hepatosplenomegaly and mesenteric and pancreaticoduodenal lymphadenopathy. Fine-needle aspiration of the pancreaticoduodenal lymph node, followed by routine Romanowsky and Ziehl-Neelsen stains, revealed numerous macrophages containing myriad acid-fast bacilli, leading to identification of mycobacteriosis. Autopsy and histologic examination confirmed the presence of disseminated, poorly defined, acid-fast, bacilli-rich granulomas in the pancreaticoduodenal and mesenteric lymph nodes, intestines, and lungs. Destaining of May-Grünwald/Giemsa-stained slides with alcohol, and then restaining with Ziehl-Neelsen, revealed acid-fast rods and avoided repeat tissue sampling without affecting the Ziehl-Neelsen stain quality and cytologic features. Tissue samples were submitted for a PCR assay targeting the heat shock protein gene ( hsp65) and revealed 100% homology with Mycobacterium genavense. We emphasize the use of special stains and PCR for identification of this potential zoonotic agent.
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Affiliation(s)
- Bérengère Dequéant
- LHA-Laboniris, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation Nantes, France (Dequéant)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, Biopôle, Unité d’Histologie, d’Embryologie et d’Anatomie pathologique, Département des Sciences Biologiques et Pharmaceutiques, Maisons-Alfort, France (Pascal, Bilbault, Cordonnier, Reyes-Gomez)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, ANSES, INRA, Maisons-Alfort, France (Boschiroli)
- Pathology Department, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation, Nantes, France (Dagher)
| | - Quentin Pascal
- LHA-Laboniris, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation Nantes, France (Dequéant)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, Biopôle, Unité d’Histologie, d’Embryologie et d’Anatomie pathologique, Département des Sciences Biologiques et Pharmaceutiques, Maisons-Alfort, France (Pascal, Bilbault, Cordonnier, Reyes-Gomez)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, ANSES, INRA, Maisons-Alfort, France (Boschiroli)
- Pathology Department, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation, Nantes, France (Dagher)
| | - Héloïse Bilbault
- Héloïse Bilbault, Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, Biopôle, Unité d’Histologie, d’Embryologie et d’Anatomie pathologique, Département des Sciences Biologiques et Pharmaceutiques, 7 rue du General de Gaulle, 94700, Maisons-Alfort, France.
| | - Elie Dagher
- LHA-Laboniris, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation Nantes, France (Dequéant)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, Biopôle, Unité d’Histologie, d’Embryologie et d’Anatomie pathologique, Département des Sciences Biologiques et Pharmaceutiques, Maisons-Alfort, France (Pascal, Bilbault, Cordonnier, Reyes-Gomez)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, ANSES, INRA, Maisons-Alfort, France (Boschiroli)
- Pathology Department, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation, Nantes, France (Dagher)
| | - Maria-Laura Boschiroli
- LHA-Laboniris, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation Nantes, France (Dequéant)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, Biopôle, Unité d’Histologie, d’Embryologie et d’Anatomie pathologique, Département des Sciences Biologiques et Pharmaceutiques, Maisons-Alfort, France (Pascal, Bilbault, Cordonnier, Reyes-Gomez)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, ANSES, INRA, Maisons-Alfort, France (Boschiroli)
- Pathology Department, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation, Nantes, France (Dagher)
| | - Nathalie Cordonnier
- LHA-Laboniris, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation Nantes, France (Dequéant)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, Biopôle, Unité d’Histologie, d’Embryologie et d’Anatomie pathologique, Département des Sciences Biologiques et Pharmaceutiques, Maisons-Alfort, France (Pascal, Bilbault, Cordonnier, Reyes-Gomez)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, ANSES, INRA, Maisons-Alfort, France (Boschiroli)
- Pathology Department, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation, Nantes, France (Dagher)
| | - Edouard Reyes-Gomez
- LHA-Laboniris, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation Nantes, France (Dequéant)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, Biopôle, Unité d’Histologie, d’Embryologie et d’Anatomie pathologique, Département des Sciences Biologiques et Pharmaceutiques, Maisons-Alfort, France (Pascal, Bilbault, Cordonnier, Reyes-Gomez)
- Université Paris-Est, Ecole Nationale Vétérinaire d’Alfort, UMR BIPAR, ANSES, INRA, Maisons-Alfort, France (Boschiroli)
- Pathology Department, Oniris-Ecole Nationale Vétérinaire, Agroalimentaire et de l’Alimentation, Nantes, France (Dagher)
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De Lorenzi G, Kamphuisen K, Biscontini G, Pacciarini M, Zanoni M, Luppi A. Mycobacterium genavense Infection in a Domestic Ferret (Mustela putorius furo). Top Companion Anim Med 2018; 33:119-121. [DOI: 10.1053/j.tcam.2018.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 10/01/2018] [Accepted: 10/03/2018] [Indexed: 11/11/2022]
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Cornelis G, Reynders M, Deprez J, Vankeerberghen A, Orlent H. Disseminated Mycobacterium genavense infection in an immunocompetent adult: a case report. Clin Microbiol Infect 2018; 24:1355-1356. [PMID: 30036670 DOI: 10.1016/j.cmi.2018.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/12/2018] [Accepted: 07/16/2018] [Indexed: 11/25/2022]
Affiliation(s)
- G Cornelis
- Department of Gastroenterology and Hepatology, Medical Microbiology, AZ Sint Jan Brugge-Oostende, Brugge, Belgium
| | - M Reynders
- Department of Laboratory Medicine, Medical Microbiology, AZ Sint Jan Brugge-Oostende, Brugge, Belgium
| | - J Deprez
- Department of Gastroenterology and Hepatology, AZ Sint Rembert, Torhout, Belgium
| | - A Vankeerberghen
- Department of Laboratory Medicine, Medical Microbiology, OLV Aalst, Aalst, Belgium
| | - H Orlent
- Department of Gastroenterology and Hepatology, Medical Microbiology, AZ Sint Jan Brugge-Oostende, Brugge, Belgium.
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14
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Verma AK, Sarin R, Arora VK, Kumar G, Arora J, Singh P, Myneedu VP. Amplification of Hsp 65 gene and usage of restriction endonuclease for identification of non tuberculous rapid grower mycobacterium. Indian J Tuberc 2018; 65:57-62. [PMID: 29332650 DOI: 10.1016/j.ijtb.2017.08.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 06/08/2017] [Accepted: 08/11/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The rapid grower mycobacteria have emerged as significant group of human pathogen amongst the Runyon group IV organisms that are capable of causing infection in both the healthy and immunocompromised hosts. Study aimed to identification of species amongst rapid grower non tuberculous mycobacterial isolates by polymerase chain reaction - restriction enzyme analysis (PRA). Analysis and comparison of results with standard biochemical tests. METHODS Rapid grower non tuberculous mycobacteria had been collected from liquid culture section during the study period. All isolates were identified by conventional biochemical tests. A 441bp fragment of hsp65 genes was amplified and digested by two restriction enzymes, BstEII and HaeIII. Digested products were analyzed using polyacrilamid gel electrophoresis (PAGE). RESULTS During study, 121 rapid grower mycobacterial isolates were subjected for species identification. Isolates were obtained from pulmonary samples (72) and extrapulmonary samples (49). In the PRA test 8 different types of rapid grower mycobacteria were identified after analyzing the fragments generated through restriction enzymes. Mycobacterium chelonae (57/121) was the most common isolate in pulmonary and extrapulmonary samples. Mycobacterium fortuitum (42), Mycobacterium abscessus (11), Mycobacterium immunogen (06), Mycobacterium peregrinum (02), Mycobacterium smegmatis (01), Mycobacterium wolinskyi (01), Mycobacterium goodii (01) were identified as other species of rapid grower non tuberculous mycobacteria. CONCLUSION PRA is a rapid and accurate system for the identification of species of non tuberculous mycobacteria. Results of PRA and biochemical tests are concordant up to 98%.
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Affiliation(s)
- Ajoy Kumar Verma
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi 110030, India
| | - Rohit Sarin
- Department of TB and Chest, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi 110030, India.
| | - Vijay Kumar Arora
- Department of TB & Chest Medicine, Santosh Medical College and Hospital Ghaziabad, 201009, NCR Delhi, India
| | - Gavish Kumar
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi 110030, India
| | - Jyoti Arora
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi 110030, India
| | - Paras Singh
- Department of Molecular Medicine, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi 110030, India
| | - Vithal Prasad Myneedu
- Department of Microbiology, National Institute of Tuberculosis and Respiratory Diseases, Sri Aurobindo Marg, New Delhi 110030, India
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Abstract
The importance of mycobacteria as opportunistic pathogens, particularly members of the M. avium complex (MAC), in patients with progressive HIV infection was recognized early in the AIDS epidemic. It took longer to appreciate the global impact and devastation that would result from the deadly synergy that exists between HIV and M. tuberculosis. This HIV/M. tuberculosis co-pandemic is ongoing and claiming millions of lives every year. In addition to MAC, a number of other non-tuberculous mycobacteria have been recognized as opportunistic pathogens in HIV-infected individuals; some of these are more commonly encountered (e.g., M. kansasii) than others (M. haemophilum and M. genevense). Finally, there are challenges to concomitantly treating the HIV and the infecting Mycobacterium species, because of antimicrobial resistance, therapeutic side-effects and the complex pharmacologic interactions of the antiretroviral and antimycobacterial multidrug therapy.
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Affiliation(s)
- Gary W Procop
- Staff, Pathology and Clinical Microbiology, Cleveland Clinic, 9500 Euclid Avenue/LL2-2, Cleveland, OH 44195, United States.
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Samanta I, Bandyopadhyay S. Infectious Diseases. PET BIRD DISEASES AND CARE 2017. [PMCID: PMC7121861 DOI: 10.1007/978-981-10-3674-3_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The chapter describes bacerial, viral, parasitic and fungal infections commonly detected in pet birds. The chapter includes history, etiology, susceptible hosts, transmission, pathogenesis, clinical symptoms, lesion, diagnosis, zoonosis, Treatment and control strategy of Tuberculosis, Salmonellosis, Chlamydiosis, Campylobacteriosis, Lyme disease, other bacterial infection, Newcastle disease, Avian Influenza infection, West Nile Virus infection, Usutu virus infection, Avian Borna Virus infection, Beak and feather disease, other viral infection, Toxoplasmosis, Giardiasis, Cryptosporidiosis, other parasitic infection, Cryptococcosis, Aspergillosis, Other fungal infections.
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Ombelet S, Van Wijngaerden E, Lagrou K, Tousseyn T, Gheysens O, Droogne W, Doubel P, Kuypers D, Claes K. Mycobacterium genavenseinfection in a solid organ recipient: a diagnostic and therapeutic challenge. Transpl Infect Dis 2016; 18:125-31. [DOI: 10.1111/tid.12493] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 10/23/2015] [Accepted: 11/01/2015] [Indexed: 01/23/2023]
Affiliation(s)
- S. Ombelet
- Department of Nephrology; University Hospitals Leuven; Leuven Belgium
| | - E. Van Wijngaerden
- Department of General Internal Medicine; University Hospitals Leuven; Leuven Belgium
| | - K. Lagrou
- Department of Laboratory Medicine; University Hospitals Leuven; Leuven Belgium
| | - T. Tousseyn
- Department of Pathology; University Hospitals Leuven; Leuven Belgium
| | - O. Gheysens
- Department of Nuclear Medicine; University Hospitals Leuven; Leuven Belgium
| | - W. Droogne
- Department of Cardiology; University Hospitals Leuven; Leuven Belgium
| | - P. Doubel
- Department of Nephrology; AZ Groeninge; Kortrijk Belgium
| | - D. Kuypers
- Department of Nephrology; University Hospitals Leuven; Leuven Belgium
| | - K.J. Claes
- Department of Nephrology; University Hospitals Leuven; Leuven Belgium
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18
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Ogawa Y, Koizumi Y, Watanabe D, Hirota K, Ikuma M, Yajima K, Kasai D, Nishida Y, Uehira T, Shirasaka T. [A Case of Disseminated Mycobacterium genavense Infection in an AIDS Patient. A Case Report and a Review of the Literature]. ACTA ACUST UNITED AC 2016; 89:259-64. [PMID: 26552123 DOI: 10.11150/kansenshogakuzasshi.89.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A 44-year-old male, who was HIV seropositive, developped weight loss, high grade fever, and multiple lymphadenopathies. Bone marrow biopsy revealed a granuloma lesion, and at the same part of the specimen, Ziehl Neelsen staining showed multiple mycobacterium diffusely arranged in the histocytes. The culture did not show positive after 6 to 8 weeks. Finally we diagnosed disseminated Mycobacterium genavense using a house-keeping gene analysis including 16S rRNA sequencing of lymph punctate with fine needle aspiration and the specimen from the biopsy of the lymph node. If a specimen tests positive for Ziehl Neelsen staining smear positive, culture negative, and PCR negative for tuberculosis and Mycobacterium avium complex, we should consider M. genavense infection as one of the differential diagnoses.
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IDENTIFICATION OF MYCOBACTERIUM GENAVENSE IN A DIANA MONKEY (CERCOPITHECUS DIANA) BY POLYMERASE CHAIN REACTION AND HIGH-PERFORMANCE LIQUID CHROMATOGRAPHY. J Zoo Wildl Med 2015; 46:339-44. [PMID: 26056890 DOI: 10.1638/2013-0246r2.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A 25-yr-old Diana monkey (Cercopithecus diana) with a 1.5-yr history of chronic colitis and diarrhea was found to have disseminated granulomatous disease with intralesional acid fast bacilli. Bacilli were identified as Mycobacterium genavense by polymerase chain reaction, sequencing of the 16S-23S ribosomal RNA intergenic spacer (ITS) gene, and mycolic acid analysis by high-performance liquid chromatography. Mycobacterium genavense is a common cause of mycobacteriosis in free-ranging and captive birds. In addition, recognition of opportunistic infection in human immunodeficiency virus-positive patients is increasing. Disease manifestations of M. genavense are similar to Mycobacterium avium complex (MAC) and include fever, wasting, and diarrhea with disseminated disease. Similar clinical signs and lesions were observed in this monkey. Mycobacterium genavense should be considered as a differential for disseminated mycobacterial disease in nonhuman primates as this agent can mimic MAC and related mycobacteria.
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Wassilew N, Ciaffi L, Calmy A. Mesenterial involvement of Mycobacterium genavense infection: hard to find, hard to treat. BMJ Case Rep 2015; 2015:bcr-2014-208241. [PMID: 25976189 DOI: 10.1136/bcr-2014-208241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Mycobacterium genavense is a rare pathogen affecting severely immunosuppressed patients. We report the case of persistent relapsing M. genavense infection in a 48-year-old African man with a positive diagnosis of HIV infection. Despite being under effective antiretroviral therapy with partial immune reconstitution, he developed irreversible long-term abdominal complications, possibly due to persistent M. genavense infection and sustained inflammation. Case management consists of individual risk assessment, close follow-up and personalised treatment strategies concerning the duration of antimycobacterial therapy and early application of steroids. Patients with profound immunosuppression, a high viral load at HIV diagnosis and a high burden of M. genavense, appear to be at higher risk. The pathogenicity of this complication is not well known and its optimal management has still to be determined.
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Affiliation(s)
- Nasstasja Wassilew
- HIV/AIDS Unit, Department of Infectious Diseases, Geneva University Hospital, Geneva, Switzerland
| | - Laura Ciaffi
- HIV/AIDS Unit, Department of Infectious Diseases, Geneva University Hospital, Geneva, Switzerland
| | - Alexandra Calmy
- HIV/AIDS Unit, Department of Infectious Diseases, Geneva University Hospital, Geneva, Switzerland
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21
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Haridy M, Fukuta M, Mori Y, Ito H, Kubo M, Sakai H, Yanai T. An outbreak of Mycobacterium genavense infection in a flock of captive diamond doves (Geopelia cuneata). Avian Dis 2015; 58:383-90. [PMID: 25518432 DOI: 10.1637/10775-011714-reg.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Two diamond doves (Geopelia cuneata) in a flock of 23 birds housed in an aviary in a zoo in central Japan were found dead as a result of mycobacteriosis. Fecal samples of the remaining doves were positive for mycobacterial infection, and thus they were euthanatized. Clinical signs and gross pathology, including weight loss and sudden death and slight enlargement of the liver and intestine, were observed in a small number of birds (3/23). Disseminated histiocytic infiltration of either aggregates or sheets of epithelioid cells containing acid-fast bacilli, in the absence of caseous necrosis, were observed in different organs of the infected doves, especially lungs (23/23), intestines (9/23), livers (7/23), and hearts (6/23). Mycobacterium sp. was isolated from the livers of three birds (3/23). DNA extracted from frozen liver and formalin-fixed, paraffin-embedded tissues (5/23) were used for amplification of the gene encoding mycobacterial 65-kDa heat shock protein (hsp65). The causative Mycobacterium species was identified by PCR-restriction fragment length polymorphism analysis. Mycobacterium genavense infection was confirmed in three of the diamond doves. Moreover, partial 16S rDNA gene sequencing revealed 100% identity across the three samples tested, and 99.77% nucleotide homology of the isolate sequence to M. genavense. The main route of M. genavense infection in the diamond doves was most likely airborne, suggesting a potential zoonotic risk of airborne transmission between humans and birds.
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22
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Mycobacterium genavense Infections in a Tertiary Hospital and Reviewed Cases in Non-HIV Patients. PATHOLOGY RESEARCH INTERNATIONAL 2014; 2014:371370. [PMID: 24693456 PMCID: PMC3945967 DOI: 10.1155/2014/371370] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 01/10/2014] [Indexed: 11/18/2022]
Abstract
Mycobacterium genavense is a relatively new species of nontuberculous mycobacterium reported to cause disseminated infections in patients with AIDS and later on in non-HIV immunosuppressed patients. We describe clinical and laboratory features and response to therapy in 7 patients, three of them with HIV infection and four non-HIV-three organ transplant recipients and one with hyper-IgE syndrome-in Valencia, Spain, in a ten years period. We then summarize the published cases of M. avium complex infection, with invasion of peripheral blood, liver, spleen, bone marrow, lymph nodes, and lungs. In clinical samples a large number of acid-fast bacilli were observed. M. genavense grew only from liquid media and after a prolonged incubation period. Its identification was accomplished through molecular methods. Patients were treated with prolonged combinations of antimicrobial agents. There was clinical favourable outcome in 4 patients.
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23
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Disseminated infection with Mycobacterium tilburgii in a male immunocompromised patient. J Clin Microbiol 2014; 52:1777-9. [PMID: 24523470 DOI: 10.1128/jcm.03148-13] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Mycobacterium tilburgii is a nonculturable nontuberculous mycobacterium identifiable only by molecular methods. We report a case of disseminated M. tilburgii infection illustrating the importance of 16S rRNA gene sequencing to determine the responsible mycobacterial pathogen and the difficulties in tailoring antimycobacterial treatment in the absence of a culturable organism.
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Mycobacterium genavense specific mesenteritic syndrome in HIV-infected patients: a new entity of retractile mesenteritis? AIDS 2013; 27:2819-22. [PMID: 24231409 DOI: 10.1097/01.aids.0000433820.25415.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Abdominal mesenteritis is a rare and poorly understood gastroenterological disease. Here, we report on two identical cases of Mycobacterium genavense associated retractile mesenteritis in HIV-positive patients. A literature search retrieved only few small retrospective studies, which characterize the clinical course of this seldom infection. We propose a pathogen-specific syndrome of retractile mesenteritis in HIV-positive patients linked to Mycobacterium genavense infection on the basis of our clinical observation and literature meta-analysis with duodenal wall thickening, central mesenterial mass and vascular complications.
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25
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Charles P, Lortholary O, Dechartres A, Doustdar F, Viard JP, Lecuit M, Gutierrez MC. Mycobacterium genavense infections: a retrospective multicenter study in France, 1996-2007. Medicine (Baltimore) 2011; 90:223-230. [PMID: 21694645 DOI: 10.1097/md.0b013e318225ab89] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Mycobacterium genavense, a nontuberculous mycobacterium, led to devastating infections in patients with acquired immunodeficiency syndrome (AIDS) before highly active antiretroviral therapy (HAART) was available, as well as in other immunocompromised patients. We conducted the current study to describe the features of this infection in patients infected with human immunodeficiency virus (HIV) in the HAART era and in non HIV-infected patients.We conducted a retrospective cohort survey in France. All patients with M. genavense infection diagnosed from 1996 to 2007 at the National Reference Center, Institut Pasteur, Paris, were identified and their clinical, laboratory, and microbiologic data were centralized in a single database. Twenty-five cases of M. genavense infection originating from 19 centers were identified. Twenty patients had AIDS, 3 had solid organ transplantation, and 2 had sarcoidosis. Sixty-four percent (n = 16) were male, mean age was 42 years, and median CD4 count was 13/mm (range, 0-148/mm) in patients with AIDS. Twenty-four patients had disseminated infection with fever (75%, n = 18), weight loss (79%, n = 19), abdominal pain (71%, n = 17), diarrhea (62.5%, n = 15), splenomegaly (71%, n = 17), hepatomegaly (62.5%, n = 15), or abdominal adenopathy (62.5%, n = 15). M. genavense was isolated from the lymph node (n = 13), intestinal biopsy (n = 9), blood (n = 6), sputum (n = 3), stool (n = 3), and bone marrow (n = 5). Eleven patients (44%) died, 8 (32%) were considered cured with no residual symptoms, and 6 (24%) had chronic symptoms. The 1-year survival rate was 72%.The prognosis of M. genavense infection in HIV-infected patients has dramatically improved with HAART. Clinical presentations in HIV and non-HIV immunocompromised patients were similar.
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Affiliation(s)
- Pierre Charles
- From Université Paris Descartes, Hôpital Necker-Enfants Malades (APHP), Service des Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur (PC, OL, JPV, ML), Paris; Hôpital Foch, Service de Médecine Interne (PC), Suresnes; Institut Pasteur, Département Infection et Epidémiologie (OL, FD, ML, MCG), Paris; INSERM U 738, Hôpital Hôtel-Dieu, Centre d'Epidémiologie Clinique (APHP), Université Paris V (AD), Paris; Inserm (ML), Avenir U 604
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Gomez G, Saggese MD, Weeks BR, Hoppes SM, Porter BF. Granulomatous encephalomyelitis and intestinal ganglionitis in a spectacled Amazon parrot (Amazona albifrons) infected with Mycobacterium genavense. J Comp Pathol 2011; 144:219-22. [PMID: 20888000 DOI: 10.1016/j.jcpa.2010.08.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 05/28/2010] [Accepted: 08/11/2010] [Indexed: 10/19/2022]
Abstract
An approximately 30-year-old male spectacled Amazon parrot (Amazona albifrons) was presented with a 2-week history of ataxia, head shaking, weight loss and seizures. Gross findings on necropsy examination included atrophy of the musculature, ruffled feathers and minimal epicardial and abdominal fat. Microscopically, there were perivascular cuffs of macrophages with fewer lymphocytes in the grey and white matter of the brain and spinal cord. These lesions were accompanied by gliosis and mild vacuolation of the white matter. In the small intestine, up to 70% of the intestinal ganglia were effaced by infiltrates of macrophages and fewer lymphocytes. The intestinal lamina propria contained multiple inflammatory aggregates of a similar nature. Ziehl-Neelsen staining revealed the presence of numerous bacilli within the cytoplasm of macrophages in the central nervous system (CNS) and enteric ganglia. Amplification of the DNAJ gene confirmed a mycobacterial infection and subsequent polymerase chain reaction (PCR) using a species-specific primer confirmed the aetiology as Mycobacterium genavense. Infection of the CNS with Mycobacterium spp. is uncommon and has not been previously reported in a parrot. This case is unusual in that the organism exhibited tropism for neural tissue.
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Affiliation(s)
- G Gomez
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA.
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Doggett J, Strasfeld L. Disseminated Mycobacterium genavense with pulmonary nodules in a kidney transplant recipient: case report and review of the literature. Transpl Infect Dis 2011; 13:38-43. [DOI: 10.1111/j.1399-3062.2010.00545.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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28
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Theuß T, Aupperle H, Eulenberger K, Schoon HA, Richter E. Disseminated Infection with Mycobacterium genavense in a Grizzled Giant Squirrel (Ratufa macroura) Associated with the Isolation of an Unknown Mycobacterium. J Comp Pathol 2010; 143:195-8. [DOI: 10.1016/j.jcpa.2010.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2009] [Revised: 12/08/2009] [Accepted: 01/05/2010] [Indexed: 11/26/2022]
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Manarolla G, Liandris E, Pisoni G, Moroni P, Piccinini R, Rampin T. Mycobacterium genavenseand avian polyomavirus co-infection in a European Goldfinch (Carduelis carduelis). Avian Pathol 2010; 36:423-6. [PMID: 17899468 DOI: 10.1080/03079450701598390] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Systemic mycobacteriosis associated with avian polyomavirus infection was diagnosed histologically in an 8-year-old, captive European goldfinch with a history of nervous signs. Severe mycobacterial lesions were observed in the central nervous system, lungs, cervical air sacs and adrenal glands, without involvement of the gastrointestinal tract. In addition to mycobacteriosis, intranuclear inclusions, typical of polyomavirus, were identified in the adrenal glands. Polymerase chain reaction assays were used to identify Mycobacterium genavense and finch polyomavirus as the causative agents. The absence of involvement of the gastrointestinal tract and the severity of the lesions in the respiratory tract suggested that inhalation may have been the primary route of infection with M. genavense.
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Affiliation(s)
- G Manarolla
- Sezione di Anatomia Patologica Veterinaria e Patologia Aviare, Dipartimento di Patologia Animale, Igiene e Sanitá Publica Veterninaria, Università degli Studi di Milano, Italy.
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Ludwig E, Reischl U, Janik D, Hermanns W. Granulomatous pneumonia caused by Mycobacterium genavense in a dwarf rabbit (Oryctolagus cuniculus). Vet Pathol 2009; 46:1000-2. [PMID: 19429993 DOI: 10.1354/vp.08-vp-0190-l-bc] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A juvenile dwarf rabbit (Oryctolagus cuniculus) with clinical signs of dyspnea and suspected ascites was submitted for necropsy. The main macroscopic findings were a watery red pleural effusion and some whitish striated foci in the lungs. In addition, there were multifocal scars in the cortex of the kidneys. The histologic examination of the lungs showed a severe granulomatous pneumonia with detection of acid-fast bacilli, in the kidneys, an interstitial chronic lymphoplasmacellular nephritis with interstitial fibrosis, and in the brain, a multifocal granulomatous and partly necrotizing encephalitis with detection of spores, suggestive of encephalitozoonosis. In the lungs, Mycobacterium genavense was verified by polymerase chain reaction and 16S ribosomal RNA gene sequencing. To our knowledge, this is the first report of an M. genavense infection in a rabbit, with the lungs being the only affected organ. Therefore, an aerogen infection seems to be the most contemplable way of infection.
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Affiliation(s)
- E Ludwig
- Institute of Veterinary Pathology, Ludwig-Maximilians-University Munich, Veterinaerstr. 13, 80539 Munich, Germany.
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31
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Manarolla G, Liandris E, Pisoni G, Sassera D, Grilli G, Gallazzi D, Sironi G, Moroni P, Piccinini R, Rampin T. Avian mycobacteriosis in companion birds: 20-year survey. Vet Microbiol 2008; 133:323-7. [PMID: 18789612 DOI: 10.1016/j.vetmic.2008.07.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 06/12/2008] [Accepted: 07/16/2008] [Indexed: 11/28/2022]
Abstract
The causative agents of avian mycobacteriosis in pet birds are rarely identified. The aim of this study is to add information about the etiology of avian mycobacteriosis. The identification of mycobacterium species in 27 cases of avian mycobacteriosis in pet birds was investigated by polymerase chain reaction (PCR) and sequencing of a rRNA hypervariable region. Avian mycobacteriosis appeared to be an infrequent diagnosis. Interestingly, a few cases of avian mycobacteriosis were recorded in very young birds. The most commonly affected species were the canary (Serinus canarius), the Eurasian goldfinch (Carduelis carduelis) and the red siskin (Spinus cucullatus). All but one bird were infected with Mycobacterium genavense. Mycobacterium avium was identified only in one case.
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Affiliation(s)
- Giovanni Manarolla
- Università degli Studi di Milano, Dipartimento di Patologia Animale, Igiene e Sanità Pubblica Veterinaria, via Celoria 10, 20133 Milano, Italy.
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32
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Drancourt M, Berger P, Raoult D. Systematic 16S rRNA gene sequencing of atypical clinical isolates identified 27 new bacterial species associated with humans. J Clin Microbiol 2004; 42:2197-202. [PMID: 15131188 PMCID: PMC404640 DOI: 10.1128/jcm.42.5.2197-2202.2004] [Citation(s) in RCA: 137] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Clinical microorganisms isolated during a 5-year study in our hospital that could not be identified by conventional criteria were studied by 16S rRNA gene sequence analysis. Each isolate yielded a > or =1,400-bp sequence containing <5 ambiguities which was compared with the GenBank 16S rRNA gene library; 1,404 such isolates were tested, and 120 were considered unique (27 isolates) or rare (< or =10 cases reported in the literature) human pathogens. Eleven new species, "Actinobaculum massiliae," "Candidatus Actinobaculum timonae," Paenibacillus sanguinis, "Candidatus Bacteroides massiliae," Chryseobacterium massiliae, "Candidatus Chryseobacterium timonae," Paenibacillus massiliensis, "Candidatus Peptostreptococcus massiliae," "Candidatus Prevotella massiliensis," Rhodobacter massiliensis, and "Candidatus Veillonella atypica" were identified. Sixteen species were obtained from humans for the first time. Our results show the important role that 16S rRNA gene sequence-based bacterial identification currently plays in recognizing unusual and emerging bacterial diseases.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Bacteria/classification
- Bacteria/genetics
- Bacteria/isolation & purification
- Bacteria, Anaerobic/classification
- Bacteria, Anaerobic/genetics
- Bacteria, Anaerobic/isolation & purification
- Bacterial Infections/microbiology
- Bacterial Typing Techniques
- Child, Preschool
- Female
- Genes, Bacterial
- Gram-Negative Bacteria/classification
- Gram-Negative Bacteria/genetics
- Gram-Negative Bacteria/isolation & purification
- Gram-Positive Cocci/classification
- Gram-Positive Cocci/genetics
- Gram-Positive Cocci/isolation & purification
- Gram-Positive Rods/classification
- Gram-Positive Rods/genetics
- Gram-Positive Rods/isolation & purification
- Humans
- Infant, Newborn
- Male
- Middle Aged
- RNA, Bacterial/genetics
- RNA, Ribosomal, 16S/genetics
- Species Specificity
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Affiliation(s)
- M Drancourt
- Assistance Publique-Hopitaux de Marseille, Timone, Fédération de Microbiologie Clinique, et Unité des Rickettsies, CNRS UMR 6020, IFR48, Faculté de Médecine, Université de la Méditerranée, Marseille, France
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33
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Tortoli E. Impact of genotypic studies on mycobacterial taxonomy: the new mycobacteria of the 1990s. Clin Microbiol Rev 2003; 16:319-54. [PMID: 12692101 PMCID: PMC153139 DOI: 10.1128/cmr.16.2.319-354.2003] [Citation(s) in RCA: 343] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The advancement of genetic techniques has greatly boosted taxonomic studies in recent years. Within the genus Mycobacterium, 42 new species have been detected since 1990, most of which were grown from clinical samples. Along with species for which relatively large numbers of strains have been reported, some of the new species of mycobacteria have been detected rarely or even only once. From the phenotypic point of view, among the new taxa, chromogens exceed nonchromogens while the numbers of slowly and rapidly growing species are equivalent. Whereas conventional identification tests were usually inconclusive, an important role was played by lipid analyses and in particular by high-performance liquid chromatography. Genotypic investigations based on sequencing of 16S rRNA gene have certainly made the most important contribution. The investigation of genetic relatedness led to the redistribution of the species previously included in the classically known categories of slow and rapid growers into new groupings. Within slow growers, the intermediate branch related to Mycobacterium simiae and the cluster of organisms related to Mycobacterium terrae have been differentiated; among rapid growers, the group of thermotolerant mycobacteria has emerged. The majority of species are resistant to isoniazid and, to a lesser extent, to rifampin. Many of the new species of mycobacteria are potentially pathogenic, and there are numerous reports of their involvement in diseases. Apart from disseminated and localized diseases in immunocompromised patients, the most frequent infections in immunocompetent people involve the lungs, skin, and, in children, cervical lymph nodes. The awareness of such new mycobacteria, far from being a merely speculative exercise, is therefore important for clinicians and microbiologists.
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Affiliation(s)
- Enrico Tortoli
- Regional Reference Center for Mycobacteria, Microbiological and Virological Laboratory, Careggi Hospital, 50134 Florence, Italy.
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34
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Abstract
The reduction in disseminated NTM infections caused by HAART is one of the success stories in the history of HIV in the developed world. Despite this success, these diseases still occur and may have atypical presentations in patients receiving HAART. Clinicians treating HIV-infected patients must remain familiar with the diagnosis and treatment of these diseases and implement prevention strategies when indicated.
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Affiliation(s)
- Denis Jones
- School of Medicine, University of California, Mail Code 8208, 150 W. Washington Street, #100, San Diego, CA 92103, USA.
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35
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Lucas J, Lucas A, Furber H, James G, Hughes MS, Martin P, Chen SC, Mitchell DH, Love DN, Malik R. Mycobacterium genavense infection in two aged ferrets with conjunctival lesions. Aust Vet J 2000; 78:685-9. [PMID: 11098383 DOI: 10.1111/j.1751-0813.2000.tb10406.x] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mycobacterium genavense infection was diagnosed in two adult ferrets. Disseminated mycobacteriosis was diagnosed in a castrated 5-year-old sable ferret with generalised peripheral lymph node enlargement and a proliferative lesion of the conjunctiva of the nictitating membrane. The diagnosis was based on characteristic cytology and sequence analysis of the 16S rRNA gene amplified using the polymerase chain reaction from fresh biopsy material. Therapy with rifampicin, clofazimine and clarithromycin probably cured the infection. An entire 4-year-old female ferret with conjunctival swelling, serous ocular discharge and swelling of the subcutaneous tissues of the nasal bridge was diagnosed as having M genavense infection on the basis of typical cytology, histopathology and sequence analysis of 16S rRNA amplicons from formalin-fixed paraffin-embedded tissue. This patient was treated successfully using rifampicin. Both ferrets subsequently died as a result of other disease conditions, 10 and 4 months following initiation of therapy, respectively. This is the first report documenting M genavense as a cause of disseminated mycobacterial disease in ferrets. Conjunctival involvement may be a feature of disseminated mycobacteriosis in the ferret. The possibility that these infections were the consequence of a ferret retrovirus infection should be considered further.
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Affiliation(s)
- J Lucas
- University of Melbourne Veterinary Clinic and Hospital, Werribee, Victoria
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36
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Richter E, Rüsch-Gerdes S, Niemann S, Stoehr A, Plettenberg A. Detection, identification, and treatment of a novel, non-cultivable Mycobacterium species in an HIV patient. AIDS 2000; 14:1667-8. [PMID: 10983659 DOI: 10.1097/00002030-200007280-00028] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- E Richter
- Forschungszentrum Borstel, National Reference Center for Mycobacteria, Germany
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37
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Matsiota-Bernard P, Vildé F, Nauciel C. Mycobacterium genavense infection in normal and immunodeficient mice. Microbes Infect 2000; 2:575-80. [PMID: 10884607 DOI: 10.1016/s1286-4579(00)00369-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Mycobacterium genavense is a recently described microorganism causing disseminated infections in AIDS patients. In this study, we investigate its pathogenicity in mice and some mechanisms of the host response to this bacterium. Following an intravenous challenge of 10(6) organisms, M. genavense grew progressively in the spleens and livers of BALB/c and CBA mice over at least an 8-month period. Granulomas were present in the spleens, livers and lungs of the animals. The numbers of bacteria recovered from the spleens and livers were higher in BALB/c (Bcg(s)) than in CBA (Bcg(r)) mice from day 30. The role of the Bcg gene, in the early phase of infection, was supported by the fact that the bacterial load, on day 15, was higher in BALB/c than in the congenic C.D2 (Bcg(r)) mice. The role of T cells in the host response was suggested by the high susceptibility of nude mice to M. genavense infection. In vivo depletion experiments in CBA mice indicated that gamma interferon and both CD4(+) and CD8(+) T cells participate in the containment of the bacterial load.
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Affiliation(s)
- P Matsiota-Bernard
- Laboratoire de Microbiologie, Faculté de Médecine de Paris-Ouest, Université Paris 5, 92380, Garches, France
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38
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Thomsen VO, Dragsted UB, Bauer J, Fuursted K, Lundgren J. Disseminated infection with Mycobacterium genavense: a challenge to physicians and mycobacteriologists. J Clin Microbiol 1999; 37:3901-5. [PMID: 10565904 PMCID: PMC85841 DOI: 10.1128/jcm.37.12.3901-3905.1999] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In the present study we compared the clinical presentations of patients with a clinical diagnosis of AIDS and disseminated Mycobacterium genavense infection (n = 12) with those of patients with AIDS and disseminated M. avium complex (MAC) infection (n = 24). Abdominal pain was seen more frequently in the group of patients infected with M. genavense than in patients infected with MAC (P = 0. 003). Analysis of microbiological data revealed that stool specimens from patients infected with M. genavense were more often smear positive than stool specimens from patients infected with MAC (P = 0. 00002). However, M. genavense could be cultured on solid media from only 15.4% of the stool specimens, whereas MAC could be cultured from 71.4% of the specimens. Bone marrow and liver biopsy specimens yielded growth of M. genavense within a reasonably short time, allowing species identification by DNA technology. Microbiological data clearly demonstrated the importance of acidic liquid medium for primary culture, the avoidance of pretreatment and the use of additives in culture, and the necessity for prolonged incubation if M. genavense is suspected. Susceptibility testing showed that M. genavense is sensitive to rifamycins, fluoroquinolones, and macrolides, whereas it is resistant to isoniazid. Susceptibility to ethambutol and clofazimine could not be evaluated. The mean survival times of patients in the two groups were similar.
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Affiliation(s)
- V O Thomsen
- Department of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark.
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39
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Affiliation(s)
- A Pozniak
- St Stephens Centre, Chelsea and Westminster Hospital, London, UK
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40
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Realini L, De Ridder K, Hirschel B, Portaels F. Blood and charcoal added to acidified agar media promote the growth of Mycobacterium genavense. Diagn Microbiol Infect Dis 1999; 34:45-50. [PMID: 10342107 DOI: 10.1016/s0732-8893(99)00014-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Ten different agar media were tested for the in vitro growth of Mycobacterium genavense in primary cultures and in subcultures from BACTEC vials. These agar media were based on Middlebrook 7H9, 7H10 and 7H11, and supplemented with additives: mycobactin J, yeast extract, charcoal, or defibrinated sheep blood. Some media were acidified with phosphoric acid to a final pH of 6.2 +/- 0.2. Fourteen M. genavense strains from nude mouse organs as well as one decontaminated clinical specimen (from a bird) were tested. The optimal medium for primary cultures of M. genavense was Middlebrook 7H11 acidified to pH 6.2 +/- 0.2 and supplemented with charcoal and sheep blood: on this medium, all strains produced colonies within 6-12 weeks of incubation in numbers approaching the number of bacilli inoculated. It was also the only medium to support the growth of the decontaminated clinical specimen. Added blood and charcoal appeared not as essential for subcultures as for primary cultures. Three media supported the growth of all strains within 1 month incubation: they were acidified, and were supplemented with yeast extract or pancreatic digest of casein, and with either blood or charcoal.
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Affiliation(s)
- L Realini
- Department of Microbiology, Mycobacteriology Unit, Institute of Tropical Medicine, Antwerp, Belgium
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41
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Hughes MS, Ball NW, Love DN, Canfield PJ, Wigney DI, Dawson D, Davis PE, Malik R. Disseminated Mycobacterium genavense infection in a FIV-positive cat. J Feline Med Surg 1999; 1:23-9. [PMID: 11919012 DOI: 10.1016/s1098-612x(99)90006-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
An 8-year-old FIV-positive Australian cat was presented with coughing, periocular alopecia, pyrexia and inappetence. Skin scrapings demonstrated Demodex cati mites. Antibiotics were administered and it was treated successfully for periocular demodectic mange, but the cat continued to exhibit respiratory signs and lose weight. Further investigation revealed an ascarid infection and active chronic inflammation of undetected cause affecting the lower airways. Repetitive treatment with pyrantel failed to eradicate the ascarid infection. The cat became cachectic and developed moist ulcerative dermatitis of the neck, severe non-regenerative anaemia, leucopenia and thrombocytopenia. Necropsy and histopathology revealed mycobacteriosis affecting skin, lungs, spleen, lymph nodes, liver and kidney. Attempted culture of frozen tissues at a mycobacteria reference laboratory was unsuccessful. Paraffin-embedded, formalin-fixed tissue was retrieved and examined using PCR to amplify part of the 16S rRNA gene. A diagnosis of disseminated Mycobacterium genavense infection was made based on the presence of acid fast bacteria in many tissues and partial sequence of the 16S rRNA gene. Although M genavense has been identified previously as a cause of disseminated disease in AIDS patients, this is the first report of infection in a cat. It was suspected that the demodecosis, recurrent ascarid infections and disseminated M genavense infection resulted from an immune deficiency syndrome consequent to longstanding FIV infection.
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Affiliation(s)
- M S Hughes
- Veterinary Sciences Division, Department of Agriculture for Northern Ireland, Stormont, Belfast BT4 3SD, Northern Ireland
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42
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Chevrier D, Oprisan G, Maresca A, Matsiota-Bernard P, Guesdon JL. Isolation of a specific DNA fragment and development of a PCR-based method for the detection of Mycobacterium genavense. FEMS IMMUNOLOGY AND MEDICAL MICROBIOLOGY 1999; 23:243-52. [PMID: 10219597 DOI: 10.1111/j.1574-695x.1999.tb01245.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The rise of Mycobacterium genavense infections is making identification ever more important for diagnosis and treatment. Moreover, isolation and identification of M. genavense are made difficult by the lack of growth on solid media and by its low generation rate in BACTEC liquid media. Thus, amplification by PCR or similar techniques represents the only possibility of detecting and identifying M. genavense from tissue samples. In order to set up a simple and species-specific method based on the use of PCR and non-radioactive hybridization technique, we decided to search for and clone a specific DNA fragment of this bacterial species. In the present study, a 1734-bp fragment was isolated. This fragment was found to be highly specific for M. genavense strains. A species-specific pair of primers (MG22 and MG23) and two oligonucleotide probes (MG18 and MG19) were selected. They were successfully used to amplify and detect a 155-bp DNA fragment from the 13 available strains of M. genavense which were isolated from clinical specimens or from birds. Conversely, the primers and probes did not hybridize with DNA from any of the 20 other mycobacterial species tested. It is worth noting that the chosen primers and probes did not hybridize with DNA of M. simiae, although it is closely related to M. genavense. The present PCR technique uses species-specific primers for M. genavense. Followed by a non-radioactive hybridization technique on microplates it is able to distinguish M. genavense from other mycobacteria in one step, without sequencing or restriction analysis. On the basis of the Southern blot hybridization, PCR and sandwich hybridization results, we concluded that the isolated 1.7-kb sequence was specific for the M. genavense chromosome. The method developed here for M. genavense identification uses a simple methodology and commonly available reagents. Furthermore it can be easily automated.
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Affiliation(s)
- D Chevrier
- Laboratoire de Prédéveloppement des Sondes, Centre de Biologie Médicale Spécialisée, Institut Pasteur, Paris, France
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43
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Realini L, De Ridder K, Palomino J, Hirschel B, Portaels F. Microaerophilic conditions promote growth of Mycobacterium genavense. J Clin Microbiol 1998; 36:2565-70. [PMID: 9705393 PMCID: PMC105163 DOI: 10.1128/jcm.36.9.2565-2570.1998] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Our studies show that microaerophilic conditions promote the growth of Mycobacterium genavense in semisolid medium. The growth of M. genavense at 2.5 or 5% oxygen was superior to that obtained at 21% oxygen in BACTEC primary cultures (Middlebrook 7H12, pH 6.0, without additives). By using nondecontaminated specimens, it was possible to detect growth with very small inocula (25 bacilli/ml) of 12 different M. genavense strains (from nude mice) within 6 weeks of incubation under low oxygen tension; conversely, with 21% oxygen, no growth of 8 of 12 (66.7%) M. genavense strains was detected (growth index, <10). The same beneficial effect of 2.5 or 5% oxygen was observed in primary cultures of a decontaminated clinical specimen. Low oxygen tension (2.5 or 5%) is recommended for the primary isolation of M. genavense. Microaerophilic cultivation of other atypical mycobacteria, especially slow-growing (e.g., Mycobacterium avium) and difficult-to-grow (e.g., Mycobacterium ulcerans) species, is discussed.
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Affiliation(s)
- L Realini
- Mycobacteriology Unit, Department of Microbiology, Institute of Tropical Medicine, Antwerp, Belgium.
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44
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Tortoli E, Brunello F, Cagni AE, Colombrita D, Dionisio D, Grisendi L, Manfrin V, Moroni M, Passerini Tosi C, Pinsi G, Scarparo C, Simonetti MT. Mycobacterium genavense in AIDS patients, report of 24 cases in Italy and review of the literature. Eur J Epidemiol 1998; 14:219-24. [PMID: 9663512 DOI: 10.1023/a:1007401305708] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Mycobacterium genavense is a frequently missed agent of disseminated disease in AIDS patients. The increasing frequency with which such organism is being isolated in Italy suggested a comparison of local survey with data reported in literature. Isolates presumed to belong to the species M. genavense were centralized and identified by means of genomic sequencing and/or HPLC analysis of cell wall mycolic acids; clinical data were obtained from relevant patients' record and collected using a proper questionnaire. In 24 cases in which this organism has been isolated in Italy M. genavense was grown, prevalently from blood, in liquid medium after an average of six weeks of incubation. In overwhelming majority, patients were males, presented other opportunistic diseases and were characterized by very low CD4+ counts (average 23/microl); most frequent symptoms were fever, anemia and weight loss. All but two patients, who died before the mycobacterial infection was diagnosed, were treated with at least three drugs; the mean survival was close to one year. A review of literature reports revealed a wide overlapping of clinical and microbiological features.
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Affiliation(s)
- E Tortoli
- Laboratorio di Microbiologia e Virologia, Ospedale di Careggi, Firenze, Italy.
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45
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Carlson LD, Wallis CK, Coyle MB. Standardized BACTEC method to measure clarithromycin susceptibility of Mycobacterium genavense. J Clin Microbiol 1998; 36:748-51. [PMID: 9508306 PMCID: PMC104619 DOI: 10.1128/jcm.36.3.748-751.1998] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A standardized clarithromycin susceptibility test for Mycobacterium genavense is reported. The BACTEC radiometric broth dilution test method recommended for Mycobacterium avium complex was modified to develop a reliable and reproducible procedure. Test development involved optimization of medium pH and inoculum densities for antibiotic vials as well as growth control vials. MIC control organisms included Mycobacterium simiae, Mycobacterium avium, and Mycobacterium xenopi. Growth control vials required two to three inoculum dilutions, which varied for each species. Clarithromycin MICs and MBCs for 12 isolates and 1 colonial variant of M. genavense ranged from < or = 0.06 to 0.25 microg/ml.
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Affiliation(s)
- L D Carlson
- Department of Laboratory Medicine, Harborview Medical Center, University of Washington, Seattle 98104, USA
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46
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Chou S, Chedore P, Kasatiya S. Use of gas chromatographic fatty acid and mycolic acid cleavage product determination to differentiate among Mycobacterium genavense, Mycobacterium fortuitum, Mycobacterium simiae, and Mycobacterium tuberculosis. J Clin Microbiol 1998; 36:577-9. [PMID: 9466781 PMCID: PMC104582 DOI: 10.1128/jcm.36.2.577-579.1998] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Three Mycobacterium genavense strains and three American Type Culture Collection reference strains each of Mycobacterium fortuitum, Mycobacterium simiae, and Mycobacterium tuberculosis were subcultured onto Mycobacteria 7H11 agar (Difco Laboratories, Detroit, Mich.) supplemented with mycobactin J (Allied Laboratories, Fayette, Mo.). After 4 weeks of incubation at 37 degrees C in 10% CO2, the cultures were analyzed by gas-liquid chromatography (GLC) for their fatty acids and mycolic acid cleavage products. M. fortuitum was clearly differentiated from M. genavense by the presence of the specific marker 2-methyloctadecenoic acid in M. fortuitum and by the ratio of tetracosanoic acid to hexacosanoic acid. This ratio was <1 for M. genavense and >3 for M. fortuitum. M. fortuitum also contained docosanoic acid, which was not detected in M. genavense. M. genavense, M. simiae, and M. tuberculosis, which have similar GLC profiles, were also differentiated from each other by the presence of either cis-10-hexadecenoic acid or cis-11-hexadecenoic acid and by tetradecanoic acid content.
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Affiliation(s)
- S Chou
- Public Health Laboratory, Ontario Ministry of Health, Ottawa, Canada.
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47
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Realini L, Van Der Stuyft P, De Ridder K, Hirschel B, Portaels F. Inhibitory effects of polyoxyethylene stearate, PANTA, and neutral pH on growth of Mycobacterium genavense in BACTEC primary cultures. J Clin Microbiol 1997; 35:2791-4. [PMID: 9350735 PMCID: PMC230063 DOI: 10.1128/jcm.35.11.2791-2794.1997] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
We report on the influences of polyoxyethylene stearate (POES), PANTA, and pH on primary cultures of Mycobacterium genavense in BACTEC vials. As a model for primary cultures from tissue, seven different strains first isolated from AIDS patients (five from Switzerland and two from the United States) were inoculated into nude mice in order to obtain large amounts of bacilli to test different conditions simultaneously. Our results demonstrate that the size of the inoculum (10[6] acid-fast bacilli/vial), an acid pH (pH 6.0), and the absence of additives (POES and PANTA) significantly (P < 0.001) increased the probability of a successful culture in 1 month, considering growth index (GI) of > or =100 or a GI of > or =999 as criterion of success. In logistic regression analysis, all factors maintained a significant (P < 0.001) independent effect, and no interactions were observed between them. The best conditions for the primary cultures of M. genavense were the use of Middlebrook 7H12 medium at pH 6.0 without any additives.
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Affiliation(s)
- L Realini
- Division of Infectious Diseases, Hôpital Cantonal, Geneva, Switzerland.
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48
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Tartaglione T. Treatment of nontuberculous mycobacterial infections: role of clarithromycin and azithromycin. Clin Ther 1997; 19:626-38; discussion 603. [PMID: 9377608 DOI: 10.1016/s0149-2918(97)80088-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The incidence of identification of nontuberculous mycobacteria has increased since the advent of the acquired immunodeficiency syndrome epidemic. Although Mycobacterium avium complex appears to be responsible for most episodes of nontuberculous disease, several other previously rare species are increasingly being detected, including Mycobacterium kansasii, Mycobacterium fortuitum/chelonei complex, and Mycobacterium genavense. This review briefly summarizes the epidemiology and clinical features of these infections, as well as therapeutic and preventive strategies in immunosuppressed patients with nontuberculous mycobacterial infections. Of clinical relevance, nontuberculous mycobacterial infections are difficult to treat and do not respond to traditional antituberculous agents. The search for more effective treatment regimens is ongoing in an attempt to enhance survival and reduce morbidity among immunocompromised patients. Novel antimicrobial combinations that include clarithromycin or azithromycin have been shown to be effective in treating several nontuberculous mycobacterial infections.
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49
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Dumonceau JM, Van Gossum A, Adler M, Van Vooren JP, Fonteyne PA, De Beenhouwer H, Portaels F. Detection of fastidious mycobacteria in human intestines by the polymerase chain reaction. Eur J Clin Microbiol Infect Dis 1997; 16:358-63. [PMID: 9228475 DOI: 10.1007/bf01726363] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The aim of this study was to determine whether difficult-to-grow mycobacteria are present in human intestines. Intestinal tissue samples were subjected to both mycobacterial culture and a polymerase chain reaction (PCR) assay. After detection by PCR, species identity was determined by hybridizing the amplified 16S rRNA gene fragments with species-specific oligonucleotides. Intestinal biopsies from 63 patients with noninflammatory bowel diseases (n = 22), Crohn's disease (n = 31), or ulcerative colitis (n = 10) were analyzed. Culture and PCR revealed mycobacteria in four (6%) and 25 (40%) samples, respectively. Samples positive by PCR were negative with all probes specific to nine common cultivable species but were positive with Mycobacterium genavense-specific probe in 68% of cases. Mycobacterial isolates were identified as Mycobacterium gordonae and Mycobacterium chelonae. Findings were similar in Crohn's disease samples compared to non-Chron's disease samples. This study shows that difficult-to-grow mycobacteria can be detected by PCR in large and similar proportions of inflamed intestinal tissue from patients with inflammatory bowel disease and intestinal tissue that appears normal from patients with noninflammatory bowel disease.
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Affiliation(s)
- J M Dumonceau
- Department of Gastroenterology and Hepato-Pancreatoloy, Hôpital Erasme, Université Libre de Bruxelles, Belgium
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50
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Abstract
The acquired immunodeficiency syndrome (AIDS) pandemic has led to greater understanding and respect for the pathogenic potential of non-tuberculous mycobacteria. Mycobacterium avium complex (MAC) has emerged as the most common systemic bacterial infection in AIDS, causing debilitating disseminated disease in late-stage HIV-infected patients. With the release of the macrolide antibiotics, clarithromycin and azithromycin, effective and well-tolerated therapeutic regimens for MAC have been developed which prolong survival and increase quality of life. The macrolides and rifabutin are also effective as preventive therapy for MAC in patients with AIDS. Mycobacterium kansasii, which causes pulmonary disease similar to tuberculosis as well as disseminated disease in AIDS, is treatable with isoniazid, rifampin and ethambutol. Clinical syndromes and therapeutic options for other non-tuberculous mycobacteria in AIDS are also reviewed.
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Affiliation(s)
- A L French
- Department of Medicine, Rush Medical College, Chicago, Illinois, USA
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